Individual
MRS. GLYNN NORA STANDIFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
201 TIM JONES HWY, BOYLE, MS 38730
(662) 719-8640
Mailing address
59 NOBLIN RD, CLEVELAND, MS 38732-9571
(662) 719-8640
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
904501
MS
207R00000X
Internal Medicine Physician
904501
MS
261Q00000X
Clinic/Center
—
MS
261QC1500X
Community Health Clinic/Center
Primary
904501
MS
Other
Enumeration date
12/06/2021
Last updated
12/06/2021
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